<layout name="layout" />
<ul class="uk-breadcrumb">
    <li><a href="__APP__">Home</a></li>
    <li><a href="__CONTROLLER__/index">My Account</a></li>
    <li><a href="__CONTROLLER__/address">Address</a></li>
    <li class="uk-active"><span>Address Details</span></li>
</ul>
<form class="uk-form uk-form-horizontal" method="post" action="__MODULE__/Customer/updateAddress">
    <input type="hidden" name="addr_id" value="{$addr_id}" />
    <div class="uk-form-row">
        <label class="uk-form-label"> First Name</label>
        <div class="uk-form-controls">
            <input type="text" required name="addr_firstname" value="{$addr_firstname}" placeholder="">
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> Last Name</label>
        <div class="uk-form-controls">
            <input type="text" required name="addr_lastname" value="{$addr_lastname}" placeholder="">
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label">Country</label>
        <div class="uk-form-controls">
            <select required ng-model="addr_country" name="addr_country" ng-change="chooseCountry()">
                <option value="">--Please choose--</option>
                <volist name=":getCountryList()" id="vo">
                    <option value="{$vo.countries_iso_code_2}">{$vo.countries_name}</option>
                </volist>
            </select>
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> State</label>
        <div class="uk-form-controls">
            <select name="addr_state" required>
                <option ng-repeat="state in state_list" value="{{state.zone_code}}">{{state.zone_name}}</option>
            </select>
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> City</label>
        <div class="uk-form-controls">
            <input type="text" required name="addr_city" value="{$addr_city}" placeholder="">
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> Street</label>
        <div class="uk-form-controls">
            <input type="text" required name="addr_street" value="{$addr_street}" placeholder="">
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> Zip</label>
        <div class="uk-form-controls">
            <input type="text" required name="addr_zip" value="{$addr_zip}" placeholder="">
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> Phone</label>
        <div class="uk-form-controls">
            <input type="text" required name="addr_phone" value="{$addr_phone}" placeholder="">
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> Gender</label>
        <div class="uk-form-controls uk-form-controls-text">
            <label>
                <input type="radio" name="addr_gender" value="1" <eq name="addr_gender" value="1">checked</eq> />&nbsp;Male</label>
            <label>
                <input type="radio" name="addr_gender" value="0" <eq name="addr_gender" value="0">checked</eq> />&nbsp;Female</label>
        </div>
    </div>
    <div class="uk-form-row">
        <label class="uk-form-label"> Type</label>
        <div class="uk-form-controls uk-form-controls-text">
            <label>
                <input type="radio" name="addr_type" value="1" <eq name="addr_type" value="1">checked</eq> />&nbsp;Billing Address</label>
            <label>
                <input type="radio" name="addr_type" value="0" <eq name="addr_type" value="0">checked</eq> />&nbsp;Shipping Address</label>
        </div>
    </div>
    <div class="uk-form-row">
        <button type="submit" class="uk-button uk-button-danger">Confirm</button>
    </div>
</form>
